Having Alzheimer’s doesn’t guarantee that you’ll move to a nursing home someday, but it certainly does increase the odds. As the disease progresses, you may begin to experience wandering and exhibit behaviors diat will become increasingly difficult for your caregiver to manage. You may also require greater physical care than your caregiver can provide.
In any case, having Alzheimer’s does mean you will probably have to move someday. In some cases, you may need to move closer to other family members who can assist in your care. In others, a spousal caregiver may opt to move to a smaller home.
For some people, there may be a need to find living arrangements that provide round-the-clock care. Keep in mind too, that as your needs change, so too may your need for different living arrangements. Below are the types of housing available.
Retirement Housing
For people who can live independently and have few health concerns, retirement housing is a viable option. These communities, which are also called senior apartments or senior living facilities, provide small studios or apartments that are equipped with cooking facilities. There may also be a common dining area or a community room for socializing. Some homes may also provide activities, some housekeeping, and a variety of activities. But these facilities do not provide health and medical care on the premises. As a result, they are not well suited for people in the more advanced stages of Alzheimer’s. They may however, be suitable for people in the early stages of the disease who want to live in a smaller home.
Assisted Living
These types of facilities, also called board and care, group homes, community-based residential facilities, or foster homes, can vary a great deal in terms of what they offer. They are best suited to people who can live somewhat independently but still need some assistance.
Assisted living facilities provide a room that may be private or shared, three meals a day, and in some cases, a small kitchenette. The places are generally staffed twenty-four hours a day, but the staff may or may not be trained to care for people with dementia, and the amount of care will vary. The facilities also provide structured activities, and may also offer laundry, transportation, and help with medication. These homes may be most appropriate for people in the early to middle stages of Alzheimer’s.
Nursing Homes
These settings are also known as skilled nursing facilities or health and rehabilitation centers. Nursing homes offer health care around the clock. Some may even feature special units just for the care of people who have dementia.
Residents typically live in a room with a bathroom and may share the room with another person. There are also common rooms for residents to gather. All activities and care are closely monitored and supervised by trained staff. For instance, a registered dietitian supervises meal preparation, and a licensed nurse provides medical care. The staff is generally trained to address the residents’ medical, spiritual, and recreational needs.
These facilities are best suited for people in the middle, late, and end stages of Alzheimer’s, though they may also benefit someone in the early stages if there are other medical needs involved.
Continuing Care Retirement Communities
Making the decision to live at a continuing care retirement community (CCRC) is typically considered a once-in-a-lifetime choice. These facilities, which are sometimes called life care communities, feature large campuses that provide all the different types of housing described above. So the campus will include residents who live independently, as well as those requiring some assistance and those who need skilled nursing around the clock. Residents move from one facility to another as their needs change. These facilities are often high-priced and may not be available to people with more modest incomes.
CHOOSING A FACILITY
It’s best to start considering the choice of a facility before you actually need to move in. The extra time will let you consider your options and help you determine which one is best suited to your needs. The most important considerations are the amount of care required and the atmosphere the patient prefers. According to the Alzheimer’s Association, there are several questions you should consider:
• Do you need twenty-four hour supervision?
• What are some characteristics of the person with Alzheimer’s that may require special skills of the staff who care for him?
• Does the person with Alzheimer’s need help taking medications?
• Do you prefer a private or a shared room?
• How much and what type of social activity do you want from the facility?
• Do you want a facility that cares only for people with dementia?
• What types of meals are required? Do all meals need to be prepared by someone else?
• How will costs be covered?
AFFORDING THE CARE
The cost of living in these types of housing can be high. Retirement homes are generally paid for only with your own money. With assisted living, you may be able to get some help from insurance and Medicaid, though Medicaid varies from state to state. Nursing home costs may be paid for through a combination of private funds, Medicaid, private insurance, and some limited help from Medicare. Early, careful planning for a potential stay in a long-term care facility, either through the purchase of long-term care insurance or through Medicaid planning, can help you meet these costs and save substantial assets, while giving everyone involved peace of mind.
It isn’t easy for people to contemplate some of these issues, especially if they’re already struggling with the early symptoms of Alzheimer’s. But making some of these decisions before you’re in the latter stages of the disease can be reassuring. Even if you cannot predict the course of the disease or what your needs will be in the future, you will have at least made your wishes known and discussed them with your family.